Provider Demographics
NPI:1760475529
Name:FREEDMAN, HOWARD M (DDS,PC)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:M
Last Name:FREEDMAN
Suffix:
Gender:M
Credentials:DDS,PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 N GRANT ST
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-3610
Mailing Address - Country:US
Mailing Address - Phone:503-266-1200
Mailing Address - Fax:503-266-6192
Practice Address - Street 1:385 N GRANT ST
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013-3610
Practice Address - Country:US
Practice Address - Phone:503-266-1200
Practice Address - Fax:503-266-6192
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD69441223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics